Individual
MS. AMANDA STAVINOHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1935 MEDICAL DISTRICT DR, CLINICAL NUTRITION, DALLAS, TX 75235-7701
(214) 456-7655
(214) 456-6287
Mailing address
6419 DEL NORTE LN, DALLAS, TX 75225-2618
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
DT81013
TX
Other
Enumeration date
11/02/2010
Last updated
09/09/2019
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